Pediatrics Division
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The UVA Pediatric Anesthesiology Division Faculty at the Battle Building Children's Hospital
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Dr. Joe O'Brien, MD updates resident, Dr. Brian Brenner, MD on a patient in the Pediatric Post Op Unit.
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Dr. Peggy McNaull, MD teaches Pediatric Anesthesiology to a resident.
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Dr. Barb Castro, MD, Chief of Pediatric Anesthesiology reviews scans with resident physicians.
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Dr. Samantha Vizzini, MD teaches Dr. Evan DaBreo, MD on a Pediatric Anesthesia case.
About
The Division of Pediatric Anesthesiology at UVA Children’s is committed to providing comprehensive, compassionate, family focused care to children of all ages.
Our fellowship-trained and board certified pediatric anesthesiologists provide over 5,300 individualized anesthetics to children in settings throughout UVA Health. These settings include the main ORs of UVA Health Tertiary Hospital, the Ambulatory Surgery Center in UVA Children’s Battle Building, and various non-OR settings located in our radiology, oncology and GI departments.
We recognize the unique challenges and stresses each family experiences in the perioperative period. Our pediatric anesthesiologists collaborate with our team of surgeons, intensivists, radiologists, and child life specialists. The team develops an anesthetic plan that ensures all needs are met in a safe, supportive and child friendly environment.
A Message from the Division Chief
Barbara Castro, M.D., Chief of Pediatric Anesthesiology & Pediatric Cardiac Anesthesiology
The Division of Pediatric Anesthesiology has four distinct missions: provide quality and comprehensive pediatric anesthesia care to children of all ages in the operative and non-operative setting, educate and inform the next generation of physicians, commit to continual improvement and innovation, and advocate for children’s health at the local and national levels.
Our division comprises 10 pediatric anesthesiologists with diverse training and interests. This promotes collaboration and innovation. We introduce residents to pediatric anesthesia early in their career and allow access to advanced level cases as they progress.
We are dedicated to quality care and participate in the Multicenter Perioperative Outcomes Group (MPOG) as a member institution. Through our membership in professional societies we routinely advocate for resources to ensure the health and safety of our patients at the local and national levels. We consider it an honor and a privilege to serve our pediatric patients at the number one Children’s Hospital in Virginia.
Our Division
Barbara A. Castro
Barbara A. Castro, MD, Pediatric & Pediatric Cardiac Anesthesia Division Chief
Dr. Castro joined the University of Virginia Department of Anesthesiology in August 1999. She is dual trained in Pediatrics and Anesthesiology. She completed her pediatric residency at Cincinnati Children’s Hospital in 1993 and anesthesiology residency at the University of Virginia in 1996. She went on to complete a Pediatric Anesthesiology Fellowship at Northwestern Children’s Memorial Hospital (now Lurie Children’s Hospital) in 1997. Dr. Castro is the current Division Chief of Pediatric Anesthesiology and Director of Pediatric Cardiac Anesthesiology. Her interests include pediatric cardiac anesthesia, pediatric airway management, neonatal anesthesia, out of OR anesthesia and quality/safety.
American Academy of Pediatric Board Certified 1993, 2001
American Board of Anesthesiology Certified 1997
Pediatric Anesthesiology Board Certified 2016
Read Dr. Castro’s Full Bio
Link to Dr. Castro’s Publications
Peggy P. McNaull, MD
Peggy P. McNaull, MD, Frederic A. Berry Professor of Anesthesiology and Chair, & Professor of Pediatrics
Dr. Peggy McNaull currently serves as the Frederic A. Berry Professor of Anesthesiology and Chair at the University of Virginia, a position she just assumed on December 1 st 2020. Prior to that role, Dr. McNaull was the Associate Chief Medical Officer for Quality and Safety for UNC Medical Center, the Director for Quality for UNC Faculty Practice, and the Vice Chair of Patient Safety and Quality Improvement for the Department of Anesthesiology. She attended medical school at Louisiana State University School of Medicine, completed her residency in Anesthesiology and fellowship in Pediatric Anesthesiology at UNC, and then completed her fellowship in Pediatric Cardiovascular Anesthesia at Texas Children’s Hospital.
Dr. McNaull is committed to advancing high quality, high value care to patients in the perioperative environment. The quality efforts that have brought her the most joy include Opioid Stewardship and Enhanced Recovery After Surgery.
Dr. McNaull is also very involved in advancing the field of Anesthesiology, specifically the specialty of Pediatric Anesthesiology. She is the Secretary and Treasurer for the Society for Pediatric Anesthesia and is an applied examiner and advanced exam editor for the American Board of Anesthesiology.
American Board of Anesthesiology Certified 2007
Pediatric Anesthesiology Board Certified 2014
Read Dr. McNaull’s Full Bio
Link to Dr. McNaull’s Publications
Keneta McKellar MD, MSc, MS
Keneta McKellar MD, MSc, MS
Dr. Kenny McKellar is an Assistant Professor of Anesthesiology in the Pediatric division. Prior to her career with the University of Virginia, Dr. McKellar attended the Albany Medical College and received her MS in Basic Life Science. Following her Master’s degree, she studied at Albert Einstein College of Medicine and earned her MD, as well as an MSc in Clinical Research Methods. She completed her Internship in Anesthesiology at Penn Presbyterian Medical Center, and went on to the Hospital of the University of Pennsylvania for her residency in Anesthesiology and Critical Care.
Dr. McKellar completed her fellowship in Pediatric Anesthesiology at the Children’s Hospital of Pennsylvania. Since 2016, Dr. McKellar has been part of The Gold Humanism honor Society, and from 2013-2018 received the Service & Research Scholarship from Albert Einstein College of Medicine. Dr. McKellar (Kenny), now lives in Charlottesville with her wife and 2 daughters.
Joseph G. O’Brien, MD
Joseph G. O’Brien, MD
Dr. O’Brien joined the University of Virginia Department of Anesthesiology in July 2019. He completed his anesthesiology residency at the Naval Medical Center in Portsmouth VA in 2006 and practiced as a Staff Pediatric Anesthesiologist. He served as Head of Anesthesia at Camp Lejuene before completing a pediatric anesthesiology fellowship at Boston Children’s Hospital in June 2019.
Dr. O’Brien’s interests include resident education, crisis management, neuroanesthesia and medical acupuncture. He is a recent winner of our resident teaching award and serves as pediatric director of our Surgical Admission Suite (SAS) and Post Anesthesia Care Unit (PACU).
American Board of Anesthesiology Certified 2007, 2018
Pediatric Anesthesiology Board Certified 2019
Read Dr. O’Brien’s Full Bio
Link to Dr. O’Brien’s Publications
George D. Politis, MD
George D. Politis, MD
Dr. Politis joined the University of Virginia Department of Anesthesiology in 2001. He completed pediatric residency training at Oakland Children’s Hospital, Oakland, CA in 1988 and worked as a pediatric hospitalist for four years. Dr. Politis completed anesthesiology residency training at UVA in 1995 followed by a fellowship in pediatric anesthesiology at Children’s Hospital of Philadelphia.
Dr. Politis directs education for UVA’s pediatric anesthesiology core rotations and has developed a 2-day orientation rotation for residents entering their first pediatric anesthesiology rotation. He is coordinator for the department’s biennial 8 week long Pediatric Anesthesiology Teaching Block. Dr. Politis has been involved in global health work for near three decades. He directs the Department of Anesthesiology Global Health Leadership Track, serves on institutional and national global health committees, and is Chair of Operation Smile International’s Anesthesia Council. His interests include resident education, global health, and regional anesthesia.
American Board of Pediatrics Certified 1989
American Board of Anesthesiology Certified 1996
Pediatric Anesthesiology Board Certified 2018
Read Dr. Politis’ Full Bio
Link to Dr. Politis’ Publications
Assistant Professor
Robert Ricketts, MD
Dr. Robert Ricketts recently joined the UVA Faculty as an Assistant Professor of Anesthesiology. Dr. Ricketts earned his medical degree from the Ohio State University in 2011, and then completed a 4-year residency in Global Child Health at the Baylor College of Medicine at Texas Children’s Hospital. From 2015-2017 he acted as Assistant Professor of Pediatrics at Baylor before making the jump to Anesthesiology and beginning his residency. He then completed a Fellowship in Pediatric Anesthesia at Johns Hopkins, but would later pursue another fellowship in Cardiothoracic Anesthesiology, and then a fellowship in Pediatric Cardiovascular Anesthesiology at Harvard University.
Over the years Dr. Ricketts has received many awards and scholarships, most recently in 2020, he was inducted into the Gold Humanism Society as a resident. His most recent research is centered on Pediatric Thoracic and Cardiovascular treatments and interventions. He and his family now reside in Charlottesville, and he is an avid Orioles Baseball fan.
American Board of Pediatrics Certified (Pediatric Medicine)
American Board of Anesthesiology Certified (Pediatric Anesthesiology)
American Board of Anesthesiology Certified (Anesthesiology)
Ruchika Sharma, MD, MBBS
Ruchika Sharma, MD, MBBS
Dr. Sharma joined the University of Virginia Department of Anesthesiology in April 2019. She received her MBBS and MD degrees from Maharaja Sayajirao University, India in 2000 and 2003. She subsequently completed a pediatric anesthesia fellowship at St. Louis Children’s Hospital in 2007 and an advanced fellowship in Pediatric Cardiac Anesthesia at Children’s Hospital Boston in 2008.
Her focus in cardiac anesthesia.
Christopher J. Stemland, MD,
Christopher J. Stemland, MD
Dr. Stemland joined the University of Virginia Department of Anesthesiology in October 2007. He completed his anesthesiology residency and pediatric anesthesiology fellowship at the University of Pittsburgh and Children’s Hospital of Pittsburgh in 2006 and 2007 respectively. His interests include liver transplantation, anesthesia for orthopedic procedures, medical simulation, and ambulatory anesthesia.
Dr. Stemland is currently serving as the Director of Out of OR Anesthesia including our adult and pediatric population.
American Board of Anesthesiology Certified 2007
Samantha J. Vizzini, MDSamantha J. Vizzini, MD
Dr. Vizzini joined the University of Virginia Department of Anesthesiology in June 2020. She completed her anesthesiology residency at the University of Miami/Jackson Memorial Hospital in 2014. She subsequently went on to do a Pediatric Anesthesia and Pediatric Cardiac Anesthesia fellowship at Nationwide Children’s Hospital finishing in 2015 and 2016 respectively.
Her interests include pediatric cardiac anesthesia, preoperative evaluation and assessment, resident/fellow education.
American Board of Anesthesiology Certified 2015
Pediatric Anesthesiology Board Certified 2015
Read Dr. Vizzini’s Full Bio
Link to Dr. Vizzini’s Publications
Lynda T Wells, MD, FRCA
Lynda T Wells, MD, FRCA
Dr. Wells joined the University of Virginia Department of Anesthesiology in January 2005. She completed her anesthesiology training at Oxford University in England in 1993.
Dr. Wells started her career in the US in 1993 at the University of Texas Houston Medical Center in Houston, TX, where she served on faculty as a pediatric anesthesiologist. In 1998, she moved to the University of Texas San Antonio Medical Center where she continued her career in pediatric anesthesia and founded a multi-disciplinary Acute Pain Service for adults and children.
At UVA she practices both pediatric anesthesia and pain medicine. Dr. Wells’ interests include pediatric pain medicine, quality improvement, liver transplant, global health and physician health and wellbeing.
American Board of Anesthesiology Certified 1997
American Board of Pain Medicine Certified 2002
Dr. Chris Stemland evaluates a pediatric patient prior to surgery.
Highlights of Our Clinical Programs
- Newly designated Pediatric PACU in 2021
- UVA Children’s ranked number 1 in the state of Virginia
- Congenital Cardiac Collaborations with Children’s Hospital of Kings Daughters in Norfolk & VCU in Richmond
- Dr. Castro & Dr. Vizzini are credentialed at Children’s Hospital of Kings Daughters & at VCU to help train their faculty in pediatric cardiac anesthesia
- Participation in STS and C3PO
- The Effect of Oral Versus Nasal Intubation on Feeding Outcomes in Neonates Requiring Cardiac Surgery
- Analysis of Anesthesia Related Severe Adverse Events in Congenital Catheterization Cases from a Single Institution
- Comparison of fibrinogen concentrate & cryoprecipitate in pediatric cardiac surgery patients
Books and Chapters:
McNaull PP. “The Opioid Epidemic and Children.” In: Smiths Anesthesia for Infants and Children, Tenth Edition. Elsevier, Philadelphia, PA; 2022, Video content.
McNaull PP, Suchar A. “Fluids, Electrolytes, and Nutrition.” In: Gregory’s Pediatric Anesthesia.
John Wiley & Sons, Inc, Oxford, UK; 2020: 54 pages.
McNaull PP, Waller E. “Don’t let the surgeon discharge every pediatric patient.” In: Avoiding
Common Anesthesia Errors, 2 nd edition. Lippincott Williams & Wilkins, Baltimore, Maryland;
2020: 7 pages.
Refereed Papers/Articles:
Marulanda K, Purcell LN, Strassle PD, McCauley CJ, Mangat SA, Chaumont N, Sadiq TS,
McNaull PP, Lupa MC, Hayes AA, Phillips MR. “A Comparison of Adult and Pediatric Enhanced Recovery after Surgery Pathways: A Move for Standardization.” Journal of Surgical
Research 2022; 269: 241-248.
Herb J, Williams B, Chen K, Chidgey BC, McNaull PP, Stitzenberg K. “The Impact of Standard Post-operative Opioid Prescribing Guidelines on Racial Differences in Opioid Prescribing: A Single Institution Experience.” Surgery 2021; 170(1): 180-185.
Isaak RS, Kolarczyk L, Blacker S, McNaull PP, Arora H, Zvara DA. “Time Will Tell: Going Beyond Relative Value Units and American Society of Anesthesiologists Units to Objectively Quantify Nonclinical Contributions in Academic Medical Practice.” Anesth Analg 2021; 132(3):
910-915.
Dorismond C, Hunter SE, McNaull PP, Zimmerman KO, Benjamin DK, Greenberg RG, Corey KM, Laughon MM, Jackson WM. “Wide range of perioperative drugs and doses used in inguinal hernia repairs for premature infants.” J Perinatol 2021;41(3):577-58.
Gessner KH, Jung J, Cook HE, Graves JL, McNaull P, Chidgey B, Mann J, Woody N, Deal AM, Coward RM, Figler B, Borawski K, Bjurlin MA, Raynor M, Tan HJ, Viprakasit D, Wallen EM, Nielsen ME, Smith AB. “Implementation of Postoperative Standard Opioid Prescribing Schedules Reduces Opioid Prescriptions without Change in Patient-reported Pain Outcomes.”
Urology 2021: 148: 126-133.
Purcell LN, Marulanda K, Egberg M, Mangat S, McCauley C, Chaumont N, Sadiq TS, Lupa C, McNaull P, McLean SE, Hayes-Jordan A, Phillips MR. “An enhanced recovery after surgery pathway in pediatric colorectal surgery improves patient outcomes.” J Pediatric Surg 2021;
56(1): 115-120.
Yaster M, McNaull PP, Davis PJ. “The opioid epidemic in pediatrics: a 2020 update.” Curr Opin Anaesthesiol 2020; 33(3): 327-334.
Hart WM, Doerr P, Qian Y, McNaull PP. “What constitutes effective team communication after an error?” AMA J Ethics 2020; 22(4): E298-304.
Phillips MR, Adamson WT, McLean SE, Hance L, Lupa MC, Pittenger SL, Dave P, McNaull PP. “Implementation of a pediatric enhanced recovery pathway decreases opioid utilization and
shortens time to full feeding.” Journal of Pediatric Surgery 2020; 55(1): 101-105.
Refereed Unpublished Oral Presentations:
McNaull PP: “Hospital Leadership – Ask the Experts.” (Invited/Oral Presentation). Given at Society for Pediatric Anesthesia Annual Meeting, Nassau, Bahamas 02/2020.
McNaull PP: “Practical Opioid Stewardship: What is a Pediatric Anesthesiologist’s Role in the
Opioid Crisis?” (Invited/Oral Presentation). Given at Society for Pediatric Anesthesia Annual
Meeting, Houston, TX 03/2019.
McNaull PP: “Review Game: Historical Figures and Images from Anesthesiology.” Given at
Society for Pediatric Anesthesia Annual Meeting, Houston, TX 03/2019.
Refereed unpublished abstracts:
McNaull PP, Castro B, Sharma R, Vizzini S, Frank D, Vergales J, Dean P, Gangemi J, Roeser M, Edelson M, Raphael J. “A pilot and feasibility study comparing fibrinogen concentrate and cryoprecipitate in children undergoing cardiac surgery.” Accepted to Society for Pediatric Anesthesia Spring Meeting, Tampa, FL 03/2022.
Yildirim MI, Castro B, McNaull P, Raphael J, Sharma R, Spaeder M, Vizzini S, Frank D. “The effect of oral versus nasal intubation on feeding outcomes in neonates requiring cardiac surgery.” (Solicited/Poster) Given at the Society of Critical Care Medicine Congress, Virtual, 02/2022.
Purcell LN, Marulanda K, Mangat S, McCauley C, Chaumont N, Sadiq T, McLean SE, Lupa C, McNaull P, Phillips MR. “Enhanced Recovery After Surgery Pathways Improve Outcomes in Pediatric Colorectal Surgery.” (Solicited/Poster) Given at the American Pediatric Surgical
Association, Virtual, 05/2020.
Marulanda K, Purcell LN, Strassle PD, Koonce R, Mangat S, McCauley C, Sadiq T, Chaumont N,
McNaull P, Lupa C, Phillips MR. “Enhanced Recovery After Surgery Pathways Improve Outcomes in Pediatric Colorectal Surgery.” (Solicited/Poster) Given at the 15 th Annual Academic Surgical Congress, Orlando, FL, 02/2020.
Bryant MK, Purcell LN, Marzinsky A, Charles AG, McLean SE, Farber L, McNaull P, Phillips MR. “Patient-reported Outcomes after Implementing Standard Opioid Prescribing for Pediatric Appendectomy.” Given at the 15 th Annual Academic Surgical Congress, Orlando, FL, 02/2020.
Ricketts K, Phillips M, Marzinsky A, Woody N, Higginbotham C, Bradford K, Farber L, Hildebrand K, Chidgey B, McNaull P. “Utilizing a length of stay algorithm to guide opioid prescribing for pediatric surgery patients: A quality improvement project.” (Solicited/Poster) given at Society for Pediatric Anesthesia Spring Meeting, Nassau, Bahamas 02/2020.
Ricketts K, Phillips M, Marzinsky A, Woody N, Higginbotham C, Bradford K, Farber L, Hildebrand K, Chidgey B, McNaull P. “Utilizing a length of stay algorithm to guide opioid prescribing for pediatric surgery patients: A quality improvement project.” (Solicited/Poster)
Given at Society for Society for Pediatric Pain Medicine Meeting, Nassau, Bahamas 02/2020.
Research Projects
Dr. Ronak Patel. 2018-Present Ongoing research: “Oral vs. Intravenous Acetaminophen for Post-Tonsillectomy Pain.”
Dr. Ronak Patel. 2017-Present Ongoing research: “Intravenous Lidocaine Infusions for Analgesia in Scoliosis Surgery.” (Affiliation with Harms Anesthesiology Study Group).
Patel, Ronak. “2 Year Old with A Large Mediastinal Mass Presenting For Biopsy and Excision.” ‘Medically Challenging Cases.’ American Society of Anesthesiologist Annual Meeting, Virtual Conference, October 3, 2020.
Politis GD, Gregory G, Yudkowitz F, Fisher Q, Bhettay A, Wexler A: “Guidelines for Conducting Plastic Reconstructive Short-Term Surgical Projects in Low-Middle Income Countries.” Pediatric Anesthesia 30:1308-1321, 2020, (Featured Cover Article). Dr. George Gregory is a largely considered one of the pioneers in pediatric anesthesiology
Electronic Forum
Politis, G. “Anesthesiology and Critical Care Forum: Implications of COVID-19 for Low-middle
Income Countries,” Electronic Forum by Operation Smile International, April 23, 2020 (Electronic Publication). The Forum was led by Doctor George Politis who served as Host/Panel Moderator, and Speaker. Dr. Politis organized experts, developed topics, led group meetings, wrote and edited most of the manuscript, obtained guideline endorsements from national and international pediatric anesthesia societies and NGOs.
Politis GD. “Anesthesia for Surgical Missions.” in Davis P, Cladis F, and Motoyama E, eds. Smith’s
Anesthesia for Infants and Children, 10 th ed., 2022 (Invited chapter in the pediatric anesthesiology textbook largely considered to be the most prestigious multi-authored text
in the field.)
Poster Presentations
Lindsay Brown, Ziyad Knio, William Kim, Marcel Durieux, Bhiken Naik, Barbara Castro, Ruchik Sharma. “Comparative incidence of adverse events during gastrostomies in infants with and without congenital heart disease (selected in the top five posters).” Congenital Cardiac Anesthesia Society Meeting, March 2021.
USA Accepted Abstracts: Adams J, Vizzini S, Romeo D. “Urgent Non-Obstetrical Surgery in a Noncompliant Parturient with Fontan Circulation Physiology” Congenital Cardiac Anesthesia Society Annual Meeting, Medically Challenging Case Presentation, Nassau Bahamas: February 2020.
Adams J, Vizzini S, Romeo D. “Urgent Non-Obstetrical Surgery in a Noncompliant Parturient with Fontan Circulation Physiology.” Society for Pediatric Anesthesia, Annual Meeting, Medically Challenging Case Presentation, Nassau Bahamas: February 2020.
EDUCATION
Residents at the University of Virginia complete their required pediatric anesthesia rotations on campus at UVA Children’s Hospital. Residents are first introduced to pediatric anesthesia in their CA-1 year. Prior to their first rotation they spend two days with a dedicated pre-peds team. Residents shadow and learn the logistics of providing care from their pre-peds team in the pediatric operating rooms, and outside of the OR locations.
Residents complete a total of 4 weeks of pediatric anesthesia in their CA-1 year, all at the main UVA Children’s Hospital. During the CA-2 year, residents are assigned higher level pediatric cases and do a rotation at the outpatient surgical center (OPSC). In the CA-3 year, residents function at the level of a fellow and are often assigned index cases in the main OR, as well as high turnover rooms at OPSC where efficiency is critical.
PEDIATRIC CARDIAC ELECTIVE
Our residents have a unique opportunity to do a three-week pediatric cardiac anesthesia rotation in their CA-3 year. During this rotation, they spend 3 days a week in the cardiac OR and one day a week in the pediatric catheterization lab. One day per week is devoted to education, highlighted by the opportunity to attend a weekly Cath Conference and participate in discussions of case selection and management by the cardiology and surgery teams.
There are no pediatric fellows at our institution. This enables our residents to participate in the care of a wide range of cases, from neonates, to adult congenital cardiac patients. The majority of cases are performed one-on-one with a pediatric cardiac anesthesiologist. This allows for close supervision and guidance while completing procedures with ample opportunity for teaching/learning.
GLOBAL HEALTH OPPORTUNITIES
Residents who would like to participate in global health initiatives easily find mentors within the Pediatric Anesthesia Division. Many attendings travel with various organizations to provide anesthetic care for pediatric patients in developing/underserved countries.
The department encourages and supports resident participation when possible and safe to do so. Residents at UVA also have the opportunity to help organize and give monthly web-based, case oriented presentations to students and residents at the University of Rwanda/Ethiopa.